If One is Looking for Meaning in Life, Does it Help to Find Meaning in Work?

People experience well-being at both global (hfe) and domain (e.g. careers) levels, and presumably people experience meaning on both levels as well. Two studies assessed whether finding meaning on one level "satisfies" people's search for meaning at the other level. Study I assessed this question by analysing survey responses from 231 undergraduate students, finding a significant inter action such that people seeking global-level meaning in life reported greater well-being and self-efficacy in choosing a career if they experienced domainlevel meaning in their careers. Study 2 used both calling-focused and traditional career workshops in an effort to experimentally induce a sense of domain-level meaning in careers in a sample of9l undergraduate students. There was a trend for people seeking global-level meaning in life to report greater reductions in depressive symptoms and increased domain-level meaning in their careers fol lowing the workshops. Together these studies suggest that people seeking global-level meaning in life are, indeed, satisfied by experiencing meaning in their careers. We discuss these results in terms of how career and workplace interventions might be tailored according to how intently people are seeking meaning

Return-to-work outcomes and usefulness of actual fit notes received by employers

Background: GPs can use the fit note to advise that a patient ‘may be fit’ or is ‘not fit’ for work. Previous employer-based research on the fit note is largely qualitative and based on general perceptions and past experience. Knowledge of the return-to-work outcomes and usefulness of actual fit notes is needed to strengthen the evidence-base and inform practice. Objective: To investigate the return-to-work outcomes of fit notes issued to employed patients, and their employers’ opinions as to the usefulness of each note. Methods: Participating organizations collecting fit notes were asked to rate the outcome and usefulness of each fit note via postal questionnaires. Quantitative data were analysed descriptively; qualitative data were analysed using thematic content analysis. Results: Five hundred and sixteen questionnaires were posted, with a 97% return rate (n = 498). More than 80% of employees (n = 44) returned to work after the expiry date of a ‘may be fit’ note compared with 43% (n = 167) of those issued with a ‘not fit’ note. Fit notes were considered more useful if they provided information on the condition and its effect on the employee’s ability to work, if they stated whether or not the employee needed reassessment and if clear advice regarding return-to-work had been provided. Conclusions: ‘May be fit’ notes are useful in helping employees return to work. However, this option is infrequently used, and the completion and content of many fit notes does not meet employers’ needs. These factors need to be urgently addressed if the fit note is to reach its full potential

Recommendations to facilitate the ideal fit note: are they achievable in practice?

Background: Although the UK fit note has been broadly welcomed as a tool to facilitate return to work, difficulties and uncertainties have resulted in wide variation in its use. Agreement on what constitutes the ‘ideal’ fit note from the perspective of all stakeholders is needed to inform best practice. A recent Delphi study conducted by the authors reached consensus on 67 recommendations for best practice in fit note use for employed patients. However, such recommendations are not necessarily followed in practice. The purpose of this study was therefore to investigate the perceived achievability of implementing these Delphi recommendations with a further reference panel of stakeholders. Methods: Potential participants were identified by the research team and study steering group. These included representatives of employers, government departments, trades unions, patient organisations, general and medical practitioners and occupational health organisations who were believed to have the knowledge and experience to comment on the recommendations. The consensus Delphi statements were presented to the participants on-line. Participants were invited to comment on whether the recommendations were achievable, and what might hinder or facilitate their use in practice. Free text comments were combined with comments made in the Delphi study that referred to issues of feasibility or practicality. These were synthesised and analysed thematically. Results: Twelve individuals representing a range of stakeholder groups participated. Many of the recommendations were considered achievable, such as improved format and use of the electronic fit note, completion of all fields, better application and revision of guidance and education in fit note use. However a number of obstacles to implementation were identified. These included: legislation governing the fit note and GP contracts; the costs and complexity of IT systems and software; the limitations of the GP consultation; unclear roles and responsibilities for the funding and delivery of education, guidance and training for all stakeholders, and the evaluation of practice. Conclusions: This study demonstrated that although many recommendations for the ideal fit note are considered achievable, there are considerable financial, legal, organisational and professional obstacles to be overcome in order for the recommendations to be implemented successfully

A code of ethical conduct for the public health profession

Aim: Agreeing on a Code of Ethical Conduct is an essential step in the formation and definition of a public health profession in its own right. In this paper we attempt to identify a limited number of key ethical principles to be reflected as professional guidance.Methods: We used a consensus building approach based on narrative review of pivotal literature and theoretical argumentation in search for corresponding terms and - in a second step - attempted to align them to a limited number of key values. The resulting draft code of ethical conduct was validated employing a framework of the Council of Europe and reviewed in two quasi Delphi rounds by members of a global think tank.Results: The alignment exercise demonstrated the acceptability of five preselected key principles: solidarity, equity, efficiency, respect for autonomy, and justice whereas three additional principles were identified during the discussion rounds: common good, stewardship, and keeping promises. Conclusions: In the context of emerging and re-emerging diseases as well as increase in lifestyle-related diseases, the proposed Code of Ethical Conduct may serve as a mirror which public health professionals will use to design and implement public health interventions. Future public health professional chambers or an analogous structure should become responsible for the acknowledgement and enforcement of the Code.

令和5年度老人保健健康増進等事業（老人保健事業推進費等補助金）「要介護認定率の変化に関する調査研究報告書」

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